10.2 Caring for Clients with Tubes and Devices

There may be situations where the HCA will provide care for clients who may have medical tubes, lines, or drains. The care should be the same regardless of any medical tube or drain the client has. Tubes, drains, and lines have different purposes depending on where they are inserted. For example, parenteral lines bypass the stomach to administer medications or nutrition through a a vein. Tubes that go directly into the gastrointestinal system and deliver nutrition for those clients who cannot eat orally are called feeding tubes, such as nasogastric tubes. (For more information on special diets and feeding tubes, see Chapter 6.4: Special Diets.) [pb_glossary id="1080"]Drainage tubes are meant to drain fluids from the body, such a urinary catheter. (For more information on drainage tubes, see Unit 7: Assisting with Elimination Needs). Regardless of the type of tube, drain, or line a client may have, the HCA will need to know how to provide personal care with attention to the complications these devices may have on the client's health and well-being and how to safely provide care without disruption to the placement of the tubes and drains. The following five principles apply to the care of lines, tubes, or drains. Knowledge of these principles should help the HCA to provide appropriate care to clients who have these kinds of tubes. 

Five Principles for Caring for Clients with Lines, Tubes, and Drains

  1. Closed cavities of the body are sterile cavities. Insertion of any tube must be performed a licensed professional with adherence to the principles of asepsis.
  2. A portal of entry that comes into contact with a non-sterile surface immediately becomes nonsterile. When disconnecting drainage tubes, such as a urinary catheter or a G-tube, the ends must be kept clean.
  3. Gravity promotes the flow of drainage from a cavity. Keep drainage tubes and collection bags at a lower level than the cavity being drained.
  4. Drainage will flow out of the tubing if the lumen is not occluded. Avoid kinks and coils in the tubing and watch that the person does not lie on the tubing. Do not clamp tubes without a prescriber’s order.
  5. Properly cleanse the site before accessing any tubing to reduce possible introduction of microorganisms into a cavity. An alcohol swab may be used to clean the entry point prior to accessing the tubing.

Caring for clients patients with multiple tubes and attachments can be challenging. Follow the guidelines in Table 10.2.1 to help you care for clients with tubes and drains.

Table 10.2.1 Guidelines and Rationale for Caring for Clients with Tubes and Devices [1]
Guideline REASON
  • Secure tubes to the skin with securement device or tape (non-allergenic).
  • Drainage bags should be secured to stretcher’s frame, client gowns, etc., as appropriate.
  • Connect tube to sterile tubing and drainage receptacle.
  • When tension is applied to the tube, the stress will be taken by the tape rather than by the tube.
  • This prevents undue stress on the drainage tube and/or accidental removal from the wound or body cavity.
  • Do not clamp tubing unless ordered
  • To ensure continuous drainage, be sure tubing is not kinked, not caught in the bed rails, not underneath the client, and free from tension when turning, etc.
  • .This helps keep wound or body cavity sterile and promotes flow of drainage.
  • Any kinks in tubing can stop drainage from the client and cause further complications.
  • Dressing around tube, if any, should be clean and dry. Sterile technique is used if it is necessary to change the dressing. Dressings around tubes should not be cut if the frayed fibres have potential to get into the wound.
  • This avoids irritation from tube rubbing the skin or from excessive drainage.
  • Frayed fibres have potential to enter wounds present increased risk of infection.
  • Record and report patency of tube and amount; colour, character, and odour of drainage; and if an unusual situation occurs in your department. If the contents of a drainage tube are spilled, the approximate amount must be reported.
  • The character and volume of drainage provide insight into wound healing.
  • Decisions about drain removal are often made in consideration of these things.
  • If you are unsure how to empty the container or how to close it, seek help.
  • Always follow agency regulations on how to clean up a blood or body fluid spill.
  • Most drainage tubes must have the ends kept sterile.
  • Important for infection prevention and control.
  • While the HCA does not need to know the exact purpose of the tube, you should know the location of the tube to understand what to expect.
  • Always follow tubes back to the point of origin
  • Some tubes are meant for drainage (JP, Hemovacs, penrose, T-tube, percutaneous drains, Foley catheters, nephrostomy), others for feeding.
  • Feeding tubes can be nasogastric (NG), nasojejunal (NJ) , percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic jejunostomy (PEJ).

When clients have tubes and attachments to aid in their recovery, HCAs are required to understand how to provide care in a safe, person-centred manner to prevent harm to the client. This section reviewed some of the types of tubes and lines that HCAs may be exposed to in all settings.

Learning Activity - hover your cursor over to find the answer

  1. Data source: BCIT, 2015a; Perry et al., 2018 ↵
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Personal Care Skills for Health Care Assistants - 2nd Edition Copyright © 2023 by Tracy Christianson and Kimberly Morris, Thompson Rivers University is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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